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JAMA Dermatology Clinicopathological Challenge |

Painful Perianal Papules in a Middle-Aged Woman QUIZ

Cristian D. Gonzalez, BS, BA1; Catherine G. Chung, MD2; Jennie T. Clarke, MD3
[+] Author Affiliations
1University of Utah School of Medicine, Salt Lake City
2Departments of Dermatology and Pathology, Penn State Hershey Medical Center, Hershey, Pennsylvania
3Department of Dermatology, University of Utah, Salt Lake City
JAMA Dermatol. 2016;152(7):833-835. doi:10.1001/jamadermatol.2016.0143.
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A woman in her 50s with a history of Crohn disease was referred for evaluation of painful perianal skin growths that had been present for 1 year; physical examination revealed a tender perianal plaque with a papular, cobblestone-like surface. What is your diagnosis?

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A, Multiple flesh-colored perianal papules and a pebbly plaque in a middle-aged woman with Crohn disease. B, A biopsy specimen of the perianal plaque was obtained, and histopathology revealed a dermal perivascular and nodular infiltrate composed of aggregates of histiocytes and (C) numerous multinucleate giant cells surrounded by mature lymphocytes. Acid-fast and silver stains were negative (not shown).

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